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A systematic search in PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE was performed up to July 25, 2020. The pooled prevalence of the GI presentations was estimated using the random\u2010effects model. Pairwise comparison for the outcomes was performed according to the GI manifestations' presentation and the pandemic wave of infection. Data were reported as relative risk (RR), or odds ratio and 95% confidence interval. Of 125 articles with 25,252 patients, 20.3% presented with GI manifestations. Anorexia (19.9%), dysgeusia\/ageusia (15.4%), diarrhea (13.2%), nausea (10.3%), and hematemesis (9.1%) were the most common. About 26.7% had confirmed positive fecal RNA, with persistent viral shedding for an average time of 19.2 days before being negative. Patients presenting with GI symptoms on admission showed a higher risk of complications, including acute respiratory distress syndrome (RR\u2009=\u20098.16), acute cardiac injury (RR\u2009=\u20095.36), and acute kidney injury (RR\u2009=\u20095.52), intensive care unit (ICU) admission (RR\u2009=\u20092.56), and mortality (RR\u2009=\u20092.01). Although not reach significant levels, subgroup\u2010analysis revealed that affected cohorts in the first wave had a higher risk of being hospitalized, ventilated, ICU admitted, and expired. This meta\u2010analysis suggests an association between GI symptoms in COVID\u201019 patients and unfavorable outcomes. The analysis also showed improved overall outcomes for COVID\u201019 patients during the second wave compared to the first wave of the outbreak.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.26836","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T05:54:31Z","timestamp":1612418071000},"page":"2740-2768","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Gastroenterology manifestations and COVID\u201019 outcomes: A meta\u2010analysis of 25,252 cohorts among the first and second waves"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3381-2641","authenticated-orcid":false,"given":"Rami M.","family":"Elshazli","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy Horus University \u2010 Egypt  New Damietta 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